SYNOPSISObjective. Northern Ireland has a high prevalence of childhood dental caries, reflecting heavy consumption of cariogenic snack foods. To develop a policy to promote and facilitate healthier eating, researchers, practitioners, and the school community formed a partnership, together creating the Boost Better Breaks (BBB) school-based policy. The policy was developed with and supported by dieticians, health promotion officers, teachers, school meal advisors, and local suppliers of school milk. Eighty percent of primary schools and preschool groups within the Southern Health and Social Services Board are involved in the program, which permits the consumption of only milk and fruit at break time.Methods. The authors assessed the effectiveness of the partnership using data from its first two years.Results. Results of the first two years of evaluation are positive. Initial findings indicate that the program had a positive effect in increasing the mean number of sound teeth in children attending schools in areas in which socioeconomic conditions are poor.Conclusion. This initiative suggests that collaboration can facilitate improvement in children's dental health and that careful targeting of the policy to schools in poor areas has the potential to narrow disparities.
Although growth hormone excess (acromegaly) in association with glucose intolerance and diabetes mellitus is well documented in adult medicine, it is much less common in the paediatric age group. We report the case of a 13 year-old boy who presented with tall stature secondary to a large growth hormone secreting adenoma of the pituitary gland. Random growth hormone was 630 mIU/l and did not suppress during an oral glucose tolerance test. Following debulking of the tumour, he developed diabetic ketoacidosis requiring insulin treatment, but after further surgery glucose handling returned to normal. He has been started on testosterone to arrest further increase in height.
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